Postpartum fatigue and depression: A systematic review and meta-analysis

Wilson, Nathan; Lee, Jin Joo; Bei, Bei

doi:10.1016/j.jad.2018.12.032

Cited by 70 publications

(59 citation statements)

References 80 publications

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“…In one study, breast cancer patients with high cognitive fatigue exhibited higher depressive and menopausal symptoms compared with counterparts with low cognitive fatigue [49]. A recent meta-analysis reports a strong relationship between fatigue and depressive symptoms during the first few months following childbirth, which correspond to hormonal drop during the postpartum period [50]. Around 70% of patients with chronic fatigue also suffer from depressive disorders and other affective problems.…”

Section: Discussionmentioning

confidence: 99%

Psychological Climacteric Symptoms and Attitudes toward Menopause among Emirati Women

Ali

Ahmed

Smail

2020

IJERPH

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Menopause is an inevitable developmental event that women encounter at an age of 42–54 years. The drop of estrogen levels that accompanies cessation of menstruation is associated with multiple vasomotor, physical, neuropsychological, and sexual symptoms, which may hamper quality of life. This study aimed to examine the severity of psychological symptoms and their correlates among peri- and postmenopausal Emirati women (N = 60, mean age = 54.88 ± 6 years). Participants were interviewed using the Menopause-Specific Quality of Life (MENQOL) and attitudes toward menopause scale (ATMS). In four path analysis models, vasomotor symptoms, weight gain, and fatigue had significant direct effects on symptoms of anxiety, depression (only weight gain and fatigue), and psychological distress. Fatigue significantly mediated the effects of vasomotor symptoms and weight gain on symptoms of anxiety, depression (only vasomotor symptoms), psychological distress, and memory problems. These models explained 47.6%, 44.5%, 56.6%, and 29.1% of the variances in anxiety, depression, psychological distress, and memory problems, respectively. Participants with more severe menopausal symptoms expressed more negative attitudes toward menopause though regression analysis revealed that only vasomotor symptoms could significantly contribute to ATMS scores. In conclusion, psychological distress is widespread among menopausal women, and it is associated with vasomotor symptoms, fatigue, and change of body composition (obesity). Psychological symptoms, along with vasomotor symptoms, express a key link to negative attitudes toward menopause. Therefore, interventional strategies that target psychological distress may promote coping with midlife transition and improve mental health among menopausal women.

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Section: Discussionmentioning

confidence: 99%

Psychological Climacteric Symptoms and Attitudes toward Menopause among Emirati Women

Ali

Ahmed

Smail

2020

IJERPH

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“…Mothers in the peripartum period are uniquely sensitive to developing psychopathologies, including postpartum depression (PPD). PPD can affect up to 20% of mothers and can have detrimental effects on the mother-infant dyad [1][2][3] . Although substantial evidence indicates exposure to psychosocial stress is a prominent risk factor precipitating the development of PPD [4][5][6] , the underlying neurobiological mechanisms that contribute to this disease remain largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Chronic psychosocial stress during pregnancy affects maternal behavior and neuroendocrine function and modulates hypothalamic CRH and nuclear steroid receptor expression

et al. 2020

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Postpartum depression (PPD) affects up to 20% of mothers and has negative consequences for both mother and child. Although exposure to psychosocial stress during pregnancy and abnormalities in the hypothalamic pituitary adrenal (HPA) axis have been linked to PPD, molecular changes in the brain that contribute to this disease remain unknown. This study utilized a novel chronic psychosocial stress paradigm during pregnancy (CGS) to investigate the effects of psychosocial stress on maternal behavior, neuroendocrine function, and gene expression changes in molecular regulators of the HPA axis in the early postpartum period. Postpartum female mice exposed to CGS display abnormalities in maternal behavior, including fragmented and erratic maternal care patterns, and the emergence of depression and anxiety-like phenotypes. Dysregulation in postpartum HPA axis function, evidenced by blunted circadian peak and elevation of stress-induced corticosterone levels, was accompanied by increased CRH mRNA expression and a reduction in CRH receptor 1 in the paraventricular nucleus of the hypothalamus (PVN). We further observed decreased PVN expression of nuclear steroid hormone receptors associated with CRH transcription, suggesting these molecular changes could underlie abnormalities in postpartum HPA axis and behavior observed. Overall, our study demonstrates that psychosocial stress during pregnancy induces changes in neuroendocrine function and maternal behavior in the early postpartum period and introduces our CGS paradigm as a viable model that can be used to further dissect the molecular defects that lead to PPD.

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“…Early in the postpartum period, mothers feel tired due to the delivery, and increased fatigue due to breast-feeding and infant-care [21]. There was a strong correlation between fatigue and depressive symptoms among women in the systematic review, although there was a high degree of heterogeneity between studies [22]. Because having previous disease during the postpartum period mothers do not feel fatigue, it is necessary for nurses to promote physical rest such as urging their mothers to take a nap, and to take care of their newborns.…”

Section: Care For Reducing Fatiguementioning

confidence: 91%

Predictors of Mothers’ Early Postpartum Fatigue: A Cross-Sectional Study

Kojima¹,

Asazawa²

2020

OJN

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Background: Most postpartum mothers experience fatigue. However, it was unclear which day after birth during hospitalization mothers are the most fatigued, and if the mothers' background is a factor. The aim of this study was to investigate hospitalized mothers' characteristic features, fatigue, and relaxation, and then to find the correlated factors of fatigue in order to obtain suggestions for mothers' early postpartum care. Methods: This quantitative cross-sectional descriptive correlational study occurred during May to December 2016. A purposive sample of early postpartum hospitalized mothers at a postpartum unit in a Tokyo hospital completed an anonymous self-filled questionnaire survey. The survey included respondents' characteristics, fatigue scale, and relaxation scale. Data were analyzed with descriptive statistics, independent t-test, one-way analysis of variance, multiple regression analyses, and structural equation modeling. Results: Returned questionnaires were 251 (83.4%). Fatigue was significantly higher for mothers with longer postpartum days compared to shorter postpartum days (F = 5.7, p < 0.001). Fatigue was significantly higher in mothers with a previous disease compared to no previous disease (t = 2.2, p < 0.05). The three significant predictors of Fatigue were 1) relaxation (β = −0.30, p < 0.001), 2) postpartum days (β = 0.26, p < 0.001), and 3) previous disease (β = 0.14, p < 0.05). The structural equation modeling revealed that the same factors were related to Fatigue. Conclusions: No relaxation, longer postpartum days, and previous disease were associated with Fatigue for early postpartum mothers. These results suggest that focusing on previous disease, length of postpartum days, and mother's relaxation is needed to provide full support to early postpartum mothers.

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Postpartum fatigue and depression: A systematic review and meta-analysis

Cited by 70 publications

References 80 publications

Psychological Climacteric Symptoms and Attitudes toward Menopause among Emirati Women

Psychological Climacteric Symptoms and Attitudes toward Menopause among Emirati Women

Chronic psychosocial stress during pregnancy affects maternal behavior and neuroendocrine function and modulates hypothalamic CRH and nuclear steroid receptor expression

Predictors of Mothers’ Early Postpartum Fatigue: A Cross-Sectional Study

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